ASPECTS OF NUTRITION SUPPORT PATIENTS WITH SEVERE TRAUMATIC BRAIN INJURY

Objective. To evaluate efficacy of nutrition support of severe traumatic brain injury (TBI).

Materials and methods. 78 severe TBI patients were examined. They were 71 (91 %) men and 7 (9 %) women in age of 51,0 [35,0; 59,0] years. The cognition state was 8,0 [6,0; 12,8], which was quantified by Coma Glasgow Scale (GCS). The assessment of nutritional status at admission with NRS — 2002 was performed. All patients were separated into two groups in order of protein value in nutrition support: the control group was included 24 patients with protein targets equivalent of 1,2 g of protein per kg of actual body weight per day; the main group (n=54) was got  ³1,2 g of protein per kg of actual body weight per day. Descriptive data are reported as medians and interquartile ranges (IQR) (Me [q25; q75]). Survival was analysed in categories as Kaplan — Meier plots. Cox regression analyses were performed for indexing the factors of lethal outcomes.

Results. The one patient (1,3 %) had deficiency of body weight, at the same time all patients (n=78) suffered from high risk of malnutrition (NRS — 2002 was e”3 points). Kaplan-Meier plots were reviled that when patients got more protein ( ³1,2 g of protein per kg of actual body weight per day), the risk of death would be fewer on 27 % than, if they got less protein (1,2 g of protein per kg of actual body weight per day) p=0,0101. Body weight index was the independent risk factors of death according Cox regression analyses. However, age and GCS hadn’t statistically significant influence on risk lethal outcome for 30-day ICU stay.

Conclusion. The usage of high protein nutrition support ( ³1,2 g/kg/day) would be able to lower on 27 % the risk of death of severe TBI patients in 30 days ICU period. More efficient nutrition support was combination of medical diet, enteral and parenteral nutrition.

Ключевые слова: , , ,
Автор(ы): V. V. Hancharou, V. I. Sviatlitskaya, S. Y. Komlikov